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Individual

NICOLE PALLESCO SAMALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
305 E BRANDON BLVD STE 102, BRANDON, FL 33511-5222
(813) 657-8448
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3469
FL

Other

Enumeration date
08/15/2017
Last updated
08/15/2017
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